Exam 2 Flashcards
tolerance
a person’s diminished response to a drug that is the result of repeated use. physical effect of repeated use of a drug
dependence
physical condition where the body has adapted to the presence of the drug. without the drug the person will experience withdrawals
addiction
chronic, relapsing brain disease characterized by compulsive drug seeking and use, despite harmful consequences. uncontrollable or overwhelming need to use a drug
detox
period of time it takes for body to withdraw from substance you are abusing. takes days to weeks. helps drug abusers safely stop taking drugs while avoiding dangerous withdrawal symptoms
medications used in detox
antidepressants, benzodiazepines, clonidine
CIWA scale
Clinical Institute Withdrawal Assessment for Alcohol, assesses how severe withdrawal symptoms are.
alcohol withdrawal symptoms
increased BP/HR, diaphoresis, GI distress, seizures, hallucinations, memory loss, difficulty concentrating
long term physical problems of alcohol
liver disease, heart problems, muscle weakness, pancreatitis, nerve damage, ulcers, GI bleeding, vitamin deficiency
delirium tremens
severe alcohol withdrawal. global confusion, nightmares, audiitory/visual/tactile hallucinations, sweating high BP/HR, seizures. Death in 1-4% of cases
delirium tremens treatment
reduce environmental stimuli, benzodiazepines, Haldol, fluid, thiamine, folic acid (banana bag)
medications for alcohol addiction
naltrexone, acamprosate, disulfiram
naltrexone (Vivitrol)
for alcohol or opiate addiction. blocks receptors in brain that produce alcohol’s pleasurable effects. Subdues urge to drink or use opiates. Given IM q 4 weeks
acamprosate (Campral)
for alcohol addiction. reduce symptoms of long-lasting withdrawals
disulfiram (Antabuse)
for alcohol addiction. interferes with alcohol breakdown. so acetaldehyde builds up in the body and leads to unpleasant reactions
opiate withdrawal s/s
cramps, diarrhea, runny/stuffy nose, sweating, chills, yawning, muscle pain, nausea/vomiting, anxiety, cravings, trouble sleeping
COWS (Clinical Opiate Withdrawal Scale)
assess severity of opiate withdrawals
medications for opiate withdrawals
clonidine, benzodiazepine, anti-emetics, anti-anxiety, antidepressants
medications for opiate addiction
methadone, buprenorphine, naltrexone
methadone
opiate for opiate addiction.binds to same receptors in brain as heroin and painkillers. suppresses cravings and withdrawal symptoms. clinics dispense it on a daily basis to prevent abuse
buprenorphine (Suboxone)
medication for opiate addiction. partial opiate agonist. less likely to be abused than methadone
cage assessment
5 item screening for alcohol use disorder
anhedonia
common in all types of depressive disorders. loss of interest or pleasure in doing things that you normally enjoy
major depressive disorder criteria
determined with PHQ-9. have to meet at least 5 of 9 criteria and symptoms have to be present for at least a 2 week period. at least one symptom is depressed mood or loss of interest or pleasure
9 criteria for major depressive disorder
depressed mood for most of the days everyday (irritable in children), diminished interest or pleasure in activities, significant wt loss or wt gain (change of more than 5% body wt in a month), insomnia or hypersomnia everday, psychomotor agitation or retardation, fatigue, feel worthless or inappropriate guilt, diminished ability to think/concentrate/indecisiveness, suicidal ideation or recurrent thoughts of death
SIG-E-CAPS
mnemonic for criteria for major depressive disorder. Suicide, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor, Sleep/sex
dysthymia
depressive disorder. chronic/constant depression, doesnt meet criteria for major depressive disorder
premenstrual dysphoric disorder
depressive disorder. mood change r/t menstrual cycles
psychobiotics
live organisms (probiotics) that when ingested produce benefits tho people suffering from psychiatric illness
bipolar 1 disorder
meet the criteria for at least 1 manic episode. mania. more severe
mania
in bipolar 1 disorder. abnormally and persistently elevated, expansive or irritable mood lasting at least one week. inflated self esteem, grandiosity, decreased need for sleep, more talkative than usual, distracted easily, flight of ideas, racing thoughts, increase in goal-directed activities, excessive involvement in pleasurable activities
DIG-FAST 3
criteria for mania (bipolar 1 disorder). distractibility, irresponsibility, grandiose, flight of ideas, activity/agitation, sleep, talkativeness
bipolar 2 disorder
less severe. meet criteria for hypomanic episode. no psychosis, rarely need hospitalization during hypomanic episode, substantial disruption in family, occupation, social
hypomania criteria
period of persistently elevated, expansive, irritable mood lasting at least 4 days. . inflated self esteem, grandiosity, decreased need for sleep, more talkative than usual, distracted easily, flight of ideas, racing thoughts, increase in goal-directed activities, excessive involvement in pleasurable activities
mixed
s/s of both mania and depression are present nearly every day
irreversible dementias
alzheimer disease, Huntington disease, Parkinsons
major psychiatric disorders
major depressive disorder, schizophrenia
schizophrenia spectrum disorder (SSD)
schizophrenia, schizoaffective disorder, brief psychotic disorder, schizophreniform disorder, other psychotic disorders
s/s of catatonic schizophrenia
echolalia, echopraxia, waxy flexibility, automatic obedience
echolalia
repetitive speech
echopraxia
repetitive movement
waxy flexibility
person will stay in position that you move them into
automatic obedience
robot like slow movement
psychosis
hallucinations or delusions
positive symptoms
in schizophrenia, an addition of something. delusions, hallucinations, formal though disorder
negative symptoms
in schizophrenia, absent or diminished something. flat affect, alogia, avolition, social withdrawal
alogia
lack of speech
avolition
lack of purposeful movement
cognitive symptoms
in schizophrenia. memory deficits, attention deficits, language difficulties, loss of executive functioning
schizoaffective disorder
schizophrenia plus mood disorder (MDD or Bipolar)
brief psychotic disorder
schizophrenia lasting one day to less than one month
schizophreniform disorder
schizophrenia lasting one month to less than 6 months
prodromal phase
phase of schizophrenia. early S/S lasting 1-5 years. red flags such as socially withdrawn, not taking care of ADLs, looks like depression
metabolic syndrome
cluster of increased BP, high BG, excess body fat around waist, abnormal cholesterol levels. increased risk of heart disease, stroke and diabetes. Seen at baseline for schizophrenia patients and caused by medications
infant-18 month stage
trust vs mistrust
18 months-3 years
autonomy vs shame and doubt
3-5 years
initiative vs guilt
5-13 years
industry vs inferiority
11-21
identity vs confusion
neurodevelopmental disorders
developmental deficits that impair functioning in multiple areas. intellectual disability, language/speech/communication delay, autistm, ADHD
ADHD
up to 11% affected. M>F, decrease in dopamine and norepinephrine in prefrontal cortex, S/S present in at least 2 settings for more than 6 months. present before 12 years old
ADHD S/S
inattention, hyperactivity, impulsivity
Autistic Spectrum Disorder / ASD
impairment of social interactions and communication as well as restricted, repetitive behaviors and interests
Autism S/S
repetitive behaviors, slow verbal communication, impaired language development, lack of engagement, respond inconsistent to situation.
oppositional defiant disorder
irritability and defiance of adults/authority, oppositional, vindictive, hostile, trouble making friends
personality
traits, behavior styles an patterns that make up an individual character. genetic and environmental factors, emotional regulation
emotional regulation
ability to control the flux and expression of emotion
personality disorder
a persistent, maladaptive pattern of thinking, coping OR an enduring pattern of inner experiences and behavior that deviate markedly from the expectations of the culture of the individuals who exhibit it
characteristics of personality disorder
lack insight, external response to stress, fail to accept consequences of behavior, chronicity, pervasive, maladaptive, manipulative, narcissistic, impulsive, enduring, inflexible, co-occurring disorders
cluster A personality disorder
odd or eccentric. includes paranoid, schizoid and schizotypal
cluster B personality disorder
dramatic, emotional, erratic. includes, antisocial, borderline, histrionic, narcissistic
cluster C personality disorder
anxious, fearful, insecure. include avoidant, dependent, obsessive compusive
ego-dystonic
people who are aware of their problem and are distressed by them
ego-syntonic
people who do not think they have a problem
stress
demanding situation taxes a persons resources or coping and causes a negative effect
Selye’s General Adaptation Syndrome
3 stages (depending on length of exposure to stress):
- alarm - fight or flight
- resistance - long term metabolic adjustments
- exhaustion - collapse of system
anxiety
varying degrees of uneasiness or discomfort, paired with guilt, doubt, fear and obsessions
GAD
excessive worry/anxiety, sleep disturbance, muscle tension, irritability, inability to concentrate, fatigue, restlessness, avoidance of activities with possible negative outcomes, seeks reassurance d/t worry
panic disorder/attack
intense fear or discomfort with impending doom. palpitations, pounding heart, increased HR, sweating, trembling, SOB, feeling of choking, chest pain, dizziness, paresthesia
phobia
overwhelming fear of a single object, activity or situation
agoraphobia
phobia of being alone in open or public places where escape may be difficult
specific phobia
phobia of specific object or situation (seeing blood, heights)
social phobia
phobia of situation where one might be seen and embarrassed
OCD
obsessive intrusive thoughts. fear causes anxiety and compulsive behaviors combat anxiety. unwanted and distressing. are aware of this. will do anything to reduce obsesssion
acute stress disorder
occurs within 4 weeks of an event. lasts 3 days to 1 month
PTSD
duration is > 1 month. acute is < 3 months. chronic is > 3 months
PTSD S/S
distressing memories r/t events, physiological symptoms of stress response, labile mood, cognitive disturbances, hypervigilance, flashbacks
PTSD medications
benzodiazepines, SSRI’s, TCA’s, beta blockers, atypical antipsychotics
eating disorders
disturbance in the way that you eat or how you perceive your body weight/shape and how you regulate weight
eating disorders risk factors
gender, age, family influence, emotional disorder, dieting, transitions, sports/work, media/society
criteria for anorexia
persistent restriction of energy intake (food), intense fear of gaining weight despite being underweight, disturbance in the way one’s body weight is experienced, BMI < 18.5. can be restricting or binging/purging
criteria for bulimia
recurrent episodes of binging and a sense of lack of control, recurrent inappropriate compensatory behavior to prevent wt gain (vomiting, laxatives, diuretics), at least 1 time per week for 3 months, self-eval influenced by body shape and weight
criteria for binge-eating disorder
recurrent binge eating. episodes associated with eating rapidly, eating until uncomfortably full, eating alone due to embarrassment, feeling disgusted, etc. marked distress, 1 time per week for 3 months
BMI overweight
25-29.9
BMI obese
> 30
SANE
sexual assault nurse examiner. identify injuries, assess risk of STD, collect physical evidence, assess risk of pregnancy, give referral
